Simple ‘outside-in’ depression treatment could help boatloads of people

Depression is by far the most common mental illness, affecting about 1 in 3 women during their lifetime. While we don’t know exactly what causes it or how to cure it, scientists do know some things that seem to help most people suffering from the disorder. And now we have another weapon in our arsenal against depression: behavioral activation.

Behavioral activation isn’t as complicated as it first sounds. It simply means that rather than focusing on the negative internal emotions, you focus on what in your environment is causing or worsening the depressive feelings and work on changing those things first. “BA seeks to help people understand environmental sources of their depression, and seeks to target behaviors that might maintain or worsen the depression,” says Christopher Martell, Ph.D., a behavioral activation researcher and therapist.

At first this may seem strange — if you’re depressed, shouldn’t you focus on dealing with that first? After all, if you feel like you can’t even get out of bed, how will you be able to change your environment? But there’s real science behind this “outside-in” approach. Rather than simply talking about your feelings, BA specifically targets two major behaviors that cause depression: inertia and avoidance.

“When depression zaps motivation, the BA approach is to work from the outside-in, scheduling activities and using graded task assignments to allow the client to slowly begin to increase their chance of having activity positively reinforced,” he explains, adding that BA is a shorter-term therapy than more traditional depression therapies like cognitive behavioral therapy, which uses a more “inside-out” approach that focuses on changing thoughts and feelings.

And it works. According to a new study done by the University of Exeter, people who were treated using BA saw improvements that were equal to or better than those of people in CBT. This is important because BA, like CBT, doesn’t require the use of medication, but it’s also 20 percent cheaper, more widely accessible, requires less training and takes less time than CBT.

In short? It’s easier to do — an important factor in encouraging people to seek help for their depression.